Deb's Blog

Riding the Health Care Rollercoaster: How to Keep Your Balance and Plan Ahead

As of last Friday, the GOP push to repeal and replace Obamacare (officially, the Affordable Care Act) died in the Senate when three Republicans — Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona — joined with Senate Democrats to block a stripped-down version of legislation from going to conference committee with members of the House of Representatives.

At least, it seemed as if Senate Majority Leader Mitch McConnell’s efforts to push through repeal and replace legislation were finally over, with McCain’s dramatic thumb’s down vote in the wee hours of Friday morning. But reporters have taken to calling this the Zombie Bill, because it keeps rising in a new form when everyone has written its obituary.

Sure enough, on Saturday, President Trump took to Twitter to threaten Republicans with loss of government subsidies to Congressional health insurance coverage if they didn’t keep trying: “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” he tweeted.

Medicaid Cuts Off the Table — For Now

While it’s not clear what impact that threat will have on Republican leadership, it is clear that the health care insurance exchanges are in for more rocky pricing and the risk of insurers dropping out of the marketplace. Uncertainty breeds higher costs. The President has threatened to allow Obamacare to die on the vine, starved of federal subsidies that make insurance premiums affordable for lower income citizens.

For now, however, it appears that significant cuts to Medicaid over the next decade, a central point of contention in the bill, have been taken off the chopping block. That is a major victory for disability advocates, who protested fiercely on behalf of the millions who depend on Medicaid for home- and community-based care to remain independent. Medicaid also covers nursing home care, rural health clinics, services for pregnant women, inpatient and outpatient hospital care, and more for individuals who meet financial and clinical needs criteria in each state.

Massachusetts Struggles with Rising MassHealth Costs

Here in Massachusetts, about 1.9 million people are covered by Medicaid, known as MassHealth. Enrollment has increased in recent years due to expanded eligibility under Obamacare. In fiscal year 2015, 30 percent of the Commonwealth’s $15.6 billion in Medicaid spending went to long-term care.

Rising costs for MassHealth have become a stumbling block in finalizing the fiscal year 2018 budget. Governor Charlie Baker is wrestling with state legislators over how to pay for rising MassHealth costs and whether to institute tougher eligibility rules.

How to Plan Ahead in the Midst of Uncertainty

So, what’s next? How can you plan ahead for long-term care for a loved one or even yourself in such a volatile political climate?

Our best advice is to team up with a good elder law attorney. These are legal experts who have extensive experience with issues affecting us as we age and for those with disabilities. Answering questions about eligibility, unraveling issues with getting benefits, negotiating Byzantine rules and regulations — all this and more are their specialties. An excellent resource is the National Association of Elder Law Attorneys. Membership indicates a commitment to the field. The initials CELA refer to Certified Elder Law Attorney.

As with any decision about hiring a professional consultant, get referrals and research pricing to be sure you can stay within your budget. At the same time, remember that an investment in a good elder law attorney and financial adviser may save you a considerable sum down the road — not to mention, provide you with much-needed peace of mind.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.